{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:21:50Z","timestamp":1791343310441,"version":"4.3.1"},"reference-count":118,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Anorexia Nervosa (AN) is a complex disease that impairs the metabolic, mental and physiological health of affected individuals in a severe and sometimes lethal way. Many of the common symptoms in AN patients, such as reduced food intake, anxiety, impaired gut motility or overexercising are connected to both the orexigenic gut hormone ghrelin and the dopaminergic system. Targeting the ghrelin receptor (GhrR) to treat AN seems a promising possibility in current research. However, GhrR signaling is highly complex. First, the GhrR can activate four known intracellular pathways G\u03b1q, G\u03b1i\/o, G\u03b112\/13 and the recruitment of \u03b2-arrestin. Biased signaling provides the possibility to activate or inhibit only one or a subset of the intracellular pathways of a pleiotropic receptor. This allows specific targeting of physiological functions without adverse effects. Currently little is known on how biased signaling could specifically modulate GhrR effects. Second, GhrR signaling has been shown to be interconnected with the dopaminergic system, particularly in the context of AN symptoms. This review highlights that a biased agonist for the GhrR may be a promising target for the treatment of AN, however extensive and systematic translational studies are still needed and the connection to the dopaminergic system has to be taken into account.<\/jats:p>","DOI":"10.3389\/fendo.2021.734547","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T15:24:38Z","timestamp":1632756278000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Biased Ghrelin Receptor Signaling and the Dopaminergic System as Potential Targets for Metabolic and Psychological Symptoms of Anorexia Nervosa"],"prefix":"10.3389","volume":"12","author":[{"given":"Mariam S.","family":"Khelifa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise J.","family":"Skov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte","family":"Holst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000755","article-title":"An Update on the Medical Consequences of Anorexia Nervosa","volume":"31","author":"Chidiac","year":"2019","journal-title":"Curr Opin Pediatr"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases8040046","article-title":"Fertility and Reproduction After Recovery From Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies","volume":"8","author":"Chaer","year":"2020","journal-title":"Dis (Basel Switzerland)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8020278","article-title":"Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews","volume":"8","author":"Blanchet","year":"2019","journal-title":"J Clin Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2019.00190","article-title":"The Ghrelin-AgRP Neuron Nexus in Anorexia Nervosa: Implications for Metabolic and Behavioral Adaptations","volume":"6","author":"M\u00e9quinion","year":"2019","journal-title":"Front Nutr"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2016.00256","article-title":"New Insights in Anorexia Nervosa","volume":"10","author":"Gorwood","year":"2016","journal-title":"Front Neurosci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22871","article-title":"Core Psychopathology in Anorexia Nervosa and Bulimia Nervosa: A Network Analysis","volume":"51","author":"Forrest","year":"2018","journal-title":"Int J Eat Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2019.01.001","article-title":"Ghrelin and Food Reward","volume":"148","author":"Al Massadi","year":"2019","journal-title":"Neuropharmacology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.11.021","article-title":"Is There a Role for Ghrelin in Central Dopaminergic Systems? 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